Comprehensive and appropriate development for effective results

Maternal Mortality“Even one woman dying giving life is one too many. I don’t know about you, but I am ready to get the job done.” Joyce Banda, formerly President of Malawi.Antenatal CareIn Malawi only 70% of women in labour are supervised and tended by a trained midwife, mostly at their homes in rural communities ! In the United kingdom it is illegal for a woman to knowingly undertake her labour without the presence of a midwife.The maternal mortality in 2013 was 510 in 100,000 women. Therefore increasing the number of trained midwives is essential.

This will be encouraged and partially funded by macRights to expand training in Malawi, and/or funding for training at one of Scotland’s Universities.

Ante natal clinics and conversation between mother and midwife provide an opportunity to explain to each other their understanding or misconceptions about the pregnancy; growth of the baby; how the pregnancy is observed throughout, and what is the significance of these observations. This is a time for a woman to be reassured and advised by her midwife on how the pregnancy should be managed.

According to the World Health Organization (WHO), Maternal Mortality is decreasing, but still many women are dying in relationship to pregnancy or childbirth.

by WHO estimates, over 20 years, from 1990 to 2010, the daily loss globally in maternal mortality has fallen from 1,500 to 800/100,000.

instead, they have to deliver at home possibly with no trained midwife to provide support or advice.

this presents a high risk of high blood pressure with eclampsia, fatal haemorrhage before delivery, heart failure, profound infection, or haemorrhage during or after the birth.

if labour is obstructed, (in UK this would be a neglected labour) the uterus can rupture unless skilled help is to hand.

alternatively a fistula can occur between the bladder and vagina, producing urinary incontinence which requires surgical repair for a cure. If further neglected, women are often cast out because of offensive infected urine. In addition kidney infection may result in renal failure and death.

Malnutrition in Pregnancy

is a consequence of poverty, food insecurity, or intercurrent disease.

it results in poor foetal growth, physically and intellectually.

in extreme cases this results in intra uterine death of the baby.

Good Nutrition. is rarely found in rural Malawi.

as a result of limited good agricultural land,

drought or flooding of fields,

a failure of the poor to realise the vitamin deficiency of maize ( or sima),.the principle crop.

Good Nutrition requires adequate and varied food on a regular basis, including protein, micronutrients (minerals and vitamins), carbohydrates and some fats.

In addition, a healthy intestine, free of parasites will help. So a healthy well nourished woman is more likely to have a healthy baby.

Early unwanted pregnancies Often unintended pregnancies result in a child or woman resorting to an illegal abortion. These are undertaken by misguided, untrained and inept technicians, so contributing to maternal death by haemorrhage or infection.

The view widely held by senior African political figures is that abortion should be made legal and conducted safely to reduce mortality ratios among women and adolescent girls.

Poor Reproductive Health

remains the leading cause of ill health and death for women of childbearing age throughout the world.

they suffer from unintended pregnancies,

sexually transmitted infections, including HIV, and

gender related violence.

HIV in the mother most usually results in a baby being born HIV positive via her placenta.

The Malawian government has developed a Sexual and Reproductive Health policy which includes rights. Despite this policy, young people have not been able to access adequate information to understand key sexual health risks. A Demographic Health Survey of Malawi in 2004 has shown that HIV prevalence even with school enrolments quite low, the education sector represents the most effective way to reach a large proportion of children and young people to inform them of ways to avoid HIV infection.

the education sector is a channel for promoting HIV awareness to a large audience or readership.

not only can teachers, administrators and pupils at all levels be reached, but also parents and other family members.

to have a maximum impact, governments need a strong commitment to appropriate sexual and reproductive health education and rights awareness programmes.

similar attitudes toward young girls are clearly relevant for Malawi, UK, and elsewhere.

Antenatal Care.

In Malawi only 70% of women in labour are supervised and tended by a trained midwife, most of these will be at their homes in rural communities. The maternal mortality ratio in 2013 was 510 in 100.000 women. In the United kingdom it is illegal for a woman to knowingly undertake her labour without the presence of a midwife.

Midwifery training.

Increasing the number of trained midwives is essential. This will be encouraged and partially funded by mac Rights to alter the nature of training at the midwifery college, and/or funding will be provided to “train the trainers” at one of Scotland’s university midwifery colleges. Conversation at antenatal clinics between mother and midwife provide an opportunity to explain to each other the understanding or misconceptions about the pregnancy, growth of the baby, how the pregnancy is observed throughout, and what is the significance of these observations. This is a time for a woman to be reassured or advised to discuss with the midwife how the pregnancy should be managed.

Maternal Morbidity

Illness following pregnancy is commonplace, and is a sign of a difficult pregnancy short of mortality. Such conditions include